In 2016, Michael Murphy did one of my all time favourite TED Talks. It’s entitled ‘Architecture that’s built to heal’ and he discusses architecture as a means for physical, emotional and societal healing. His inspiring talk made me feel that this is something we should make more of.
Michael Murphy was inspired to action after hearing a lecture by Dr Paul Farmer. He declared “Buildings are making people sicker. And for the poorest in the world, this is causing epidemic level problems… Where are the architects and designers to help us build and design hospitals that allow us to heal?”
The hospitals Dr Farmer was referring to, are those like the old district hospital in Butaro, Rwanda. Patients arrive with one disease and leave with another. They wait crowded in dark, humid, narrow corridors: The perfect breeding ground for drug resistant tuberculosis (TB).
Butaro’s healing architecture
A year later, Michael Murphy found himself on his way to Butaro to work with Dr Farmer to radically redesign a hospital. Some of the key changes he made are:
- The dimly lit, cramped corridors are gone. Instead, the interior is more open plan and the corridors wrap around the outside of the building, encouraging people to engage with the exterior.
- To alleviate the stifling humidity – especially when the electrical ventilation systems don’t work – a breathable building was created. Vast windows line the walls, opening up the space to the external environment and allowing the exchange of air with the outside world.
- But it was also important that the hospital was a pleasant place to be. Research has shown that patient’s who have a natural view from their hospital bed require less pain medication and recover faster than those who don’t. So it was made sure that every patient had a view.
Those factors are the only ones he mentioned directly in his video, but the architecture does so much more:
- The high ceilings make the space feels light and airy, rather than confined and dark
- The surfaces are often polished, allowing for easy cleaning
- The wards are open, allowing patients to socialise and communicate with each other, whilst a low, central dividing wall still provides some privacy.
Butaro District Hospital in Rwanda offers so much inspiration about what hospitals should be like, but when you know how it was built, you realise how deep the healing runs.
In Rwandan culture, there is a concept called ‘Ubudeke’. This refers to when a community comes together for the good of the community and everyone in it. Making use of this culture, the community were asked to help excavate and build the project. Despite using mostly hand tools, this saved a lot of time, as it can be difficult to get construction machinery to rural sites. Local rock – that is usually seen as a nuisance, by farmers – was used to build the walls of the hospital and the community were trained as stone cutters – a skill they can now share with other regions across Rwanda. Talented craftsmen were sources and a guild of local furniture markers was created to furnish the hospital. As much as possible, the team made use of the local people and their skills, making sure that everyone was included, with 50% of the workforce being local women. Murphy has coined this technique “Lo-Fab” (local fabrication) and it can be summarised by 4 pillars:
- Hire locally
- Source regionally
- Train where you can
- Invest in dignity
With the Rwandan Genocide in recent history, this was a community that needed to heal, and by giving them this project and a way to invest in their community, they have been given a way to heal. But they haven’t just healed a community, they have built a hospital that really works for patients. They have built “a hospital that allows us to heal”.
Michael Murphy is part of MASS Design Group and they are committed to answering the question: “What more can architecture do?”. In the Butaro project and many others, they have proven that architecture is able to create jobs, to bring dignity to a community and above all, “great architecture can heal”.